Institute of General Practice and Interprofessional Care Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58453, Witten, Germany.
Department of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
BMC Palliat Care. 2021 May 17;20(1):69. doi: 10.1186/s12904-021-00762-x.
Quality of life and patient self-determination are key elements in successful palliative care. To achieve these goals, a robust prediction of the remaining survival time is useful as it can provide patients and their relatives with information for individual goal setting including appropriate priorities. The Aim of our study was to assess factors that influence survival after enrollment into ambulatory palliative care.
In this cross-sectional, multicenter study (n = 14 study centers) clinical records of all palliative care patients who were treated in 2017 were extracted and underwent statistical analysis. The main outcome criterion was the association of survival time with clinical characteristics such as age, type of disease, symptoms and performance status.
A total of 6282 cases were evaluated. Median time of survival was 26 days (95 % CI: 25-27 days). The strongest association for an increased hazard ratio was found for the following characteristics: moderate/severe weakness (aHR: 1.91; 95 % CI: 1.27-2.86) Karnofsky score 10-30 (aHR: 1.80; 95 % CI: 1.67-1.95), and age > 85 (aHR: 1.50; 95 % CI: 1.37-1.64). Surprisingly, type of disease (cancer vs. non-cancer) was not associated with a change in survival time (aHR: 1.03; 95 % CI: 0.96-1.10).
In this cross-sectional study, the most relevant predictor for a short survival time in specialized ambulatory palliative care was the performance status while type of disease was irrelevant to survival.
生活质量和患者自决是成功姑息治疗的关键要素。为了实现这些目标，对剩余生存时间进行准确预测非常有用，因为它可以为患者及其家属提供信息，帮助他们进行个体化目标设定，包括确定适当的优先级。我们的研究目的是评估纳入门诊姑息治疗后影响生存的因素。
在这项横断面、多中心研究（n=14 个研究中心）中，提取了 2017 年接受姑息治疗的所有患者的临床记录并进行了统计分析。主要结局标准是生存时间与临床特征（如年龄、疾病类型、症状和功能状态）的相关性。
共评估了 6282 例病例。中位生存时间为 26 天（95%CI：25-27 天）。发现与生存时间呈正相关的最强因素为：中度/重度乏力（HR：1.91；95%CI：1.27-2.86），Karnofsky 评分为 10-30 分（HR：1.80；95%CI：1.67-1.95），年龄>85 岁（HR：1.50；95%CI：1.37-1.64）。令人惊讶的是，疾病类型（癌症与非癌症）与生存时间的变化无关（HR：1.03；95%CI：0.96-1.10）。
在这项横断面研究中，预测专门的门诊姑息治疗中患者生存时间较短的最相关预测因素是功能状态，而疾病类型与生存无关。
